For the contextual risk factors and protective practices, we obtained \(\alpha \)  = [0.88, 1.00] after the second round of coding, and for the barriers, \(\alpha \)  = 0.83 after the third round. As these are above the standard threshold of 0.8 for reliability [1]}, we then proceeded to individual coding. After coding all papers, the entire research team met to review the results,
identify second-level codes and themes [2]}, and finalize our framework.
